SUGGESTIONS 

ON 

HOME NURSING 





Class J&XJq.. 



Book. 






G)pyrightN°_ 



COPYRIGHT DEPOSIT, 



SUGGESTIONS 



ON 



HOME NURSING 



ELLEN MORRIS WOOD 



PUBLISHED BY THE 
DISTRICT NURSING ASSOCIATION OF 
NORTHERN WESTCHESTER COUNTY 






Copies of this book may be ordered from 

The District Nursing Association, 

Bedford, Westchester County, New York. 

Price, Fifteen Cents. 



■ 



COPYRIGHT, 1903, BV THE 

DISTRICT NURSING ASSOCIATION OF 
NORTHERN WESTCHESTER COUNTY 



Press of J. J. Little & Co., Astor Place, New York. 



PREFACE. 

The following notes of lectures given by- 
Miss Wood at Bedford, in March, 1900, 
were taken by Miss Delia W. Marble, and 
partially revised and rewritten by Miss 
Wood while at sea in July, shortly before 
her death. They have since been kindly cor- 
rected by several of her friends, and are 
published by the District Nursing Associa- 
tion of Northern Westchester County, for 
the use of those for whom they were orig- 
inally given. 



INTRODUCTION. 

The following notes on nursing have 
been written at the request of the District 
Nursing Association of Northern West- 
chester County, from a course of six lec- 
tures on " Home Nursing," given under 
its auspices. The author finds herself much 
embarrassed in endeavoring to make a 
clear and simple statement of the under- 
lying principles of good nursing, as much 
that is important must be omitted in so 
short a statement for use in district nursing. 
No new ideas are advanced in these pages, 
but it is hoped that by leaving out all tech- 
nical expressions, some of the simplest 
means of giving help and comfort to the 
sick which are already well known to 
trained nurses, may be brought within the 
reach of those who must care for the sick 
in their families, without the aid of special 
training for the work. 

Thanks are due to Miss D. W. Marble 
for her kind assistance, without which the 
pamphlet could not have been prepared. 



6 Introduction. 

For further information upon the sub- 
jects herein touched upon, the reader is 
referred to the text-book on " Nursing," 
by Mrs. Isabel Adams Hampton Robb. 

Ellen M. Wood. 



CONTENTS. 

PAGE 

Choice of the Sick-Room g 

Care of the Sick-Room : 

Ventilation and Heating . . . .11 

Duties of the Nurse 17 

Beds and Bed Making 24 

Baths 30 

Use of the Bed Pan 36 

Enemata or Injections 39 

Douches 43 

Outward Applications 44 

Poultices 46 

Contagious Diseases 49 

Disinfectants 51 

Cooking for the Sick 52 

Stray Notes 59 

Index 62 



THE CHOICE OF THE SICK-ROOM. 

Whenever it is possible to choose which 
room in the house shall be occupied by a 
sick person, the first and most important 
considerations are sunshine and fresh 
air, and for this reason a corner room at 
the southwest of the house is usually the 
best. 

If the patient is easily disturbed by the 
unavoidable noises of the household, it may 
be well to choose a room at the top of the 
house ; but if it is possible to keep the house 
quiet, it is best not to have the patient 
higher than the second floor on account 
of the difficulty of carrying the numerous 
articles needed in the sick-room up and 
down many flights of stairs. It is a great 
mistake to keep the sick-room darkened 
unless the brain or eyes are affected, for 
sunshine is quite as necessary as medicine 
in the cure of almost all diseases. If every 
one would remember that sunshine and 
fresh air are next in importance to whole- 
some food in keeping persons well and 



io Suggestions on Home Nursing. 

strong, and are absolutely necessary to help 
sick persons to get well, there would be 
much less serious sickness, and very few 
headaches. 

If the patient is likely to be sick for a 
long time or is suffering from any con- 
tagious disease, it is best to take out of the 
room all unnecessary furniture, carpets, 
hangings, etc. Not only is it much easier 
for the nurse to take proper care of the 
room thus arranged, but it is far better 
for the patient. If there is any brain 
trouble it is especially necessary to take all 
pictures out of the room. Every sick-room 
should have a bed, sofa, easy chair, two 
tables and such other furniture as may be 
convenient and necessary. A single bed 
about thirty-two inches high, when made 
up, is best, because the nurse can reach the 
patient from all sides, and need not bend 
over as much as is necessary in working 
over a low bed. All unnecessary wear and 
tear should be avoided both for the nurse 
and the members of the family, as they can 
do far more for the patient's comfort when 
they are in good condition than when worn 
out by unnecessary exertion. It is a great 



The Care of the Sick-Room. 11 

mistake for the nurse to keep her clothes 
on all night; take them off, if only for an 
hour. If it is necessary to use a low bed, 
have a cushion on the floor and kneel on it, 
instead of standing and bending over. Or 
a low bed can be raised by putting blocks 
of wood under the castors, or by putting on 
an extra spring bed or an extra mattress 
taken from some other bed. 



THE CARE OF THE SICK-ROOM. 

Ventilation and Heating. 

The importance of breathing plenty of 
fresh air cannot be too strongly empha- 
sized. When we breathe air into our lungs, 
we absorb from it the oxygen which is the 
part necessary to keep us alive, and in the air 
which we breathe out from our lungs there 
is a poisonous substance called carbonic 
acid gas. There are also many other im- 
purities given off into the air by our bodies. 
For this reason we find that it is necessary 
to have a constant supply of fresh air coming 
into our rooms, or we shall be breathing 
again and again the same impurities which 



12 Suggestions on Home Nursing. 

have come from our bodies, and without 
getting the necessary amount of oxygen. 

This constant supply of fresh air is 
needed both by day and by night if we are 
to be strong and well, and the larger the 
number of people in one room, the greater 
should be the fresh supply. The idea that 
night air is harmful and should be shut out 
is entirely false, for although it is more 
damp and cool than while the sun is shin- 
ing, it is made of the same gases, and is 
quite as pure as the air we breathe in the 
daytime. Unless the air comes directly 
from over some cesspool, or decaying sub- 
stance, a window should always be open in 
every occupied room, both day and night, 
or there must be some other means of 
ventilation. If every one would sleep with a 
window open two or three inches from the 
top, there would be far fewer headaches, 
better appetites, and general good health. 

For those who are sick it is even more 
important to have a constant supply of 
fresh air, than it is for those who are well, 
and indeed, however good the doctor may 
be, if the nurse does not arrange for a con- 
stant supply of this, it will be very difficult 



The Care of the Sick-Room. 13 

for the patient to recover. Of course, there 
should never be a current of air blowing 
directly upon the patient, but this can 
easily be avoided by placing a screen so as 
to direct the draught away from the bed. 
A shawl or blanket pinned over a clothes- 
horse will make a very useful screen for this 
purpose, if no other is at hand. If it is pos- 
sible to have an unused room opening into 
the sick-room, in which the windows can 
be kept open and where the fresh air can be 
warmed in cold weather, before being ad- 
mitted to the patient's room, and an open 
fire kept burning in the sick-room day and 
night, we have a very perfect kind of venti- 
lation. In this way, fresh air can come in 
through the open door between the rooms 
and the bad air will be carried up the chim- 
ney, as air which is heated is lighter than 
cold air, and always rises. 

In the summer time, a lighted candle or 
lamp should be placed in the fireplace to 
heat the air and make a current to carry 
the bad air up the chimney. Stoves which 
are tightly closed do not make the air 
better, but rather worse, as they exhaust 
the oxygen and make little or no current 



14 Suggestions on Home Nursing. 

of air from the room up the chimney as is 
the case with an open fireplace. Cool air 
being heavier than warm air, it is best to 
have the cool air come into the room as 
high up as possible, and the current of 
warm air should be started upward from 
near the floor so that all the air in the room 
may, as far as possible, be constantly 
changed. This may be done by raising the 
window about six inches and filling up the 
space at the bottom with a pillow, or better, 
with a board cut to fit the width of the 
window frame. If enough air is not ad- 
mitted between the sashes, a few small 
auger holes may be bored in the board at 
intervals of four or fivt inches. In this 
way, the chief current of air being directed 
upward between the sashes, there will not 
be a perceptible draught through the room. 
We must remember that cold air is not 
always fresh air, but on the contrary may 
be quite as impure as air that is warm. 
The sick-room should always be kept as 
warm as the doctor has ordered it to be, 
and whether this may be above seventy 
degrees Fahrenheit, or below sixty degrees, 
there should always be a constant supply 



The Care of the Sick-Room. 15 

of fresh air. Lamps as well as people ex- 
haust the oxygen from the air, and when an 
extra lamp or an additional person is to be 
for any length of time in the room, there 
should be a greater supply of fresh air. If 
the room is heated by an air-tight stove or 
by a furnace, a little dish of water should 
be kept near or on the register or stove, 
as the air is apt to get too dry when only 
the very dry heat is used. Under no cir- 
cumstances should a room ever seem close 
and stuffy to a person coming into it, and 
if it does, steps should at once be taken to 
air it thoroughly, for there is nothing worse 
for a patient and no greater reproach to a 
nurse than to have the room continuously 
close. So many persons are accustomed 
to breathing impure air that they do not 
think it a matter of any importance to try 
to avoid it. At least once a day, the patient 
should be thoroughly covered up, head and 
all, and the windows opened wide for a few 
moments, unless the outside air is very 
cold. Care should be taken not to remove 
the extra covers until the room has become 
thoroughly warm again. 

By whatever means a room is heated, it 



1 6 Suggestions on Home Nursing. 

should be kept at the same temperature, 
usually sixty-five degrees Fahrenheit, both 
day and night. Special care should be 
taken to have the sick-room warm between 
one and six a.m., and an extra blanket 
should then be added, as the vital forces are 
at their lowest between these hours. 

The sick-room should be kept scrupu- 
lously clean. Dust harbors disease and 
germs of every description and should not 
be tolerated. But it is worse than useless 
to go around with a feather duster or dry 
dust cloth, which simply dislodges the dust 
and scatters it through the air to be 
breathed into the patient's lungs. The 
proper way is to take a damp cloth and 
wipe the dust off carefully. The floor may 
be wiped up in the same way if the carpet 
has been taken up. If not, a damp cloth 
may be tied around the broom and the floor 
swept with that. This will not sweep the 
carpet thoroughly, of course, but it is 
better to leave the dust in the carpet than 
to raise a cloud of it in the air. In cases 
of bronchitis or pneumonia w T ith cough- 
ing, it is best not to dust or brush the floor 
at all, to avoid making the patient cough. 



Duties of the Nurse. 17 

Keep medicine bottles out of sight of the 
patient and do not let dishes in which food 
has been served, empty glasses, spoons, 
etc., remain in the room. Keep the room 
always neat and tidy. Fresh flowers in the 
room do no harm at all, in fact are a good 
thing, provided the water is kept fresh and 
they are removed as soon as they begin to 
wilt. Healthy growing plants are good 
also as they throw off oxygen and consume 
the poisonous carbonic acid gas and thus 
help to purify the air. No food of any kind 
should be kept in a sick-room. 

DUTIES OF THE NURSE. 

It is very much better that one person 
should assume the charge of the patient, 
and that the labor of nursing should be 
systematized, as far as possible, from the 
beginning. If there are several members 
of the family ready to share in the care of 
the sick-room, it is much better for both 
patient and nurse, that they should relieve 
each other in turn and not that two or three 
should be fussing about the room at the 
same time. When a person is very sick, 



1 8 Suggestions on Home Nursing. 

the fewer people there are about, the better. 
Do not ask questions of a sick person. 
Don't fuss or nag. Whoever assumes the 
responsibility of nursing should write down 
carefully all the doctor's directions. Noth- 
ing important should be left to uncertain 
memory, so that there should never be any 
doubt or discussion afterwards as to just 
what the doctor did say. 

Never be afraid or ashamed to ask the 
doctor any questions about the care of the 
patient, in even the simplest matters. 
Doctors are always ready and glad to 
answer any questions relating to your 
duties and the comfort and welfare of the 
patient, and if there is anything you do not 
feel sure about, or do not know how to do, 
ask the doctor. Do not ask him questions 
about his treatment or what he thinks is 
going to happen, which he might not be 
able or willing to answer. That part is 
not your business and you do not help 
matters by asking, but all instructions con- 
cerning the nursing of the patient you 
should understand clearly. Follow the 
doctor's directions exactly and conscien- 
tiously. You do not know the dangers, or 



Duties of the Nurse. 19 

the effects of the medicines, nor what may- 
be the consequences of any imprudent ac- 
tions, and it is your duty to both patient 
and doctor to follow the latter's instruc- 
tions exactly and to give his treatment a 
fair chance. If the doctor says the patient 
must not get out of bed, do not let her get 
out of bed on any account; and if the 
doctor has forbidden solid food, do not let 
any wish on the patient's part induce you 
to disobey his orders. You may think 
there is no harm in something the doctor 
has forbidden, or there is no use in restrain- 
ing the patient to the extent he has di- 
rected, but you know nothing at all about 
the possible complications that may result 
from any imprudence, and you are taking 
a very grave responsibility in following 
your own ideas in disobedience to the 
doctor's order. 

If you feel anxious and are not sure that 
everything is being done that might be 
done, do not rush off to call in another 
doctor without arranging a consultation. 
The second doctor, if he were a right- 
minded man, would refuse to take a case 
away in the middle of an illness, and it 



20 Suggestions on Home Nursing. 

would be most unfair to the doctor you had 
employed first. In such a case, ask your 
doctor to call in the other physician in con- 
sultation. A doctor is always willing to do 
this, and it is always proper to ask to have 
a consultation, whenever you feel anxious 
about the case. The doctor will often pro- 
pose it himself if the case be critical. Be 
careful not to let the patient know that you 
have not perfect confidence in the doctor. 
Make her think that everything is being 
done exactly as it should be, for any worry 
will seriously impair the chances of re- 
covery. 

Give all medicines very accurately, and 
never give any home remedies or patent 
medicines while you are giving the doctor's 
prescription, as they may have a very bad 
effect together. It is a good plan to put a 
paper over the medicine glass or bottle with 
the amount of the dose and the hour at 
which it is to be given written on it, and 
then, every time you give the medicine, 
draw a line through the hour at which you 
have given it. Then there is never any 
doubt as to whether the medicine was 
given that time or not, and if a new nurse 



Duties of the Nurse. 21 

takes your place she can tell at once when 
the next dose is due. If you forget the 
medicine at one time, do not give a double 
dose the next time to make up, and if the 
directions say every hour or every two 
hours, do not give it just when you happen 
to think of it, but be very careful to give it 
on time. 

Do not make any unnecessary noise in a 
sick-room and avoid anything that may 
make the patient nervous. Do not sit on 
the edge of the bed. Do not rock ; do not 
read a newspaper, as the rustling of the 
paper is very trying, and if you read a book, 
turn the leaves quietly. Do not stand at 
the foot of the bed. Do not wear squeaky 
shoes, nor click knitting needles nor make 
any such continuous noises which are irri- 
tating to enfeebled nerves. Never whisper. 
Speak in a quiet, natural tone. Nothing 
should be said in a sick-room which the 
patient is not to hear; go outside the door 
if you wish to consult about anything. If 
any sudden or unusual noise should be 
heard, explain it at once, saying " that is 
such and such a thing," or " I did so and 
so " — otherwise you will find that the 



22 Suggestions on Home Nursing. 

patient has been thinking of that noise, try- 
ing to decide what it was, for a long time 
afterwards. Always remember that a 
patient has nothing to occupy the mind and 
that everything assumes monstrous propor- 
tions. Do not let any unpleasant happen- 
ings or bad news be told to her. Keep her 
cheerful and tranquil as far as possible, 
remember that the longer she is sick, the 
feebler the mind and nerves become. It is 
the duty of the nurse to keep the sick-room 
quiet, and not to allow visitors or friends to 
tire the patient. Never allow more than 
one person at a time to stay in the room 
and then only for a few moments. The 
sound of talking and the effort of answer- 
ing and of making conversation is most 
exhausting to an invalid, and it is your duty 
to protect her from it. Do not in the 
patient's hearing talk yourself, nor let 
others talk, of other cases which they have 
known which may have ended fatally; and 
do not allow any discussion of symptoms or 
treatment, nor any comments upon how 
badly the patient is looking, to be made in 
her hearing. 

If you do not like to tell friends that they 



Duties of the Nurse. 23 

cannot see the invalid, ask the doctor and 
get his authority to support you. Your 
patient will get well much faster if you pro- 
tect her from this fatigue and excitement, 
and it would be well if all friends would 
remember that unless they can be of some 
real use, it is much kinder not to ask to see 
a sick person, nor to take up the family's 
time with long calls. 

While you are nursing it is very neces- 
sary for you to take care of your own 
health. You may be willing to sacrifice 
yourself to any extent, but if you are tired 
and worn, you cannot take good care of the 
patient. A sick person feels it at once if a 
nurse is overtired, and does far better with 
a nurse who is fresh and well and in good 
spirits, so that it is your duty to your 
patient to keep yourself in condition. Have 
your meals regularly, at your usual hours, 
if possible, and take time enough to eat. 
If you get into the way of taking snatches 
of food at irregular times, you will find 
yourself a nervous dyspeptic before your 
patient is well. Never have your meals in 
the sick-room; it is too fatiguing to the 
patient and may lessen her appetite. Be 



24 Suggestions on Home Nursing. 

careful to keep yourself looking neat. The 
hands should be frequently washed in warm 
water and soap, and the nails cut short and 
well scrubbed with a nail brush. 

Never wake a patient at night to give 
medicine, unless the doctor has expressly 
told you to do so. Be very careful not to 
waken a patient by sudden noises, especially 
at night. To replenish a coal fire without 
noise, put a couple of quarts of coal into 
a paper bag, or into a paper and tie it up. 
Make several of these during the day, and 
lay them on the fire as needed. 

BEDS AND BED MAKING. 

A single bed is much better than a double 
bed for sickness, as it is far easier to take 
care of the patient on it. A cot three feet 
wide makes a good bed if a single bed is not 
available. The best mattress is of hair. If 
this cannot be had, a straw mattress is very 
good, or the woven wire springs with a 
cotton mattress or heavy blanket folded 
over it. Feathers make the very w^orst bed 
there is for sickness. The heat of a feather 
bed induces perspiration and then the bed 



Beds and Bed Making, 25 

settles into hollows which gather the damp- 
ness and it is almost impossible to avoid 
bed-sores. Some people are so attached to 
a feather bed that they cannot be induced 
to leave it, but if it is possible to persuade 
the patient to do so, get rid of the feather 
bed at once. The mattress should be per- 
fectly flat ; if there are hollows in it, folded 
comfortables laid smoothly under them will 
help to even the surface, and a comfortable 
laid smoothly over the mattress may make 
it better. It may be necessary to put a 
rubber sheet over the mattress to protect 
it. If a rubber sheet is not to be had, four 
or five newspapers stitched together make 
a very good substitute ; or a sheet folded 
four double may answer the purpose. 

The under sheet should be drawn very 
tight and smooth, and it is often well to 
pin it with safety pins just under the edge 
of the mattress, to keep it smooth and free 
from wrinkles. Cotton sheets are better 
than linen, as the latter gather dampness 
and are apt to be chilly, even in warm 
weather. A draw sheet is often very useful, 
as it can be changed more easily and fre- 
quently than the other sheet. This is a 



26 Suggestions on Home Nursing. 

small sheet four feet long, two feet six 
inches wide, laid lengthwise across the 
middle of the bed, drawn very tightly and 
pinned securely to the sides of the mattress. 
This can be readily drawn out and replaced 
without disturbing the patient. The under 
sheet should be well tucked under the mat- 
tress at both ends and sides and especially 
at the head of the bed. The patient is apt 
to slip down in the bed, and the sheet is 
pulled into wrinkles unless it is fastened 
securely at the top. 

The upper sheet should be well tucked 
in at the foot, as nothing is more annoying 
than to have the bedclothes come loose at 
that place. It adds much to the comfort of 
the patient if, in putting on the upper sheets 
and blankets, you make a fold lengthwise 
three or four inches wide, in the middle of 
each just as you tuck it in at the foot of 
the bed. This makes room for the patient's 
feet and prevents the drawing of the sheet 
across the feet which gets to be so uncom- 
fortable, during a long illness. 

Blankets are best for a sick-room as they 
are lighter and warmer than quilts of any 
kind. An extra blanket will be needed at 



Beds and Bed Making. 27 

hand to put over the patient during the 
early morning hours, and also when airing 
the room. Heavy white bedspreads are 
objectionable, as they have little warmth in 
proportion to their weight. Either use no 
spread, or have a very light one, or, best of 
all, simply a sheet to spread over the 
blankets. The appearance of a bed or room 
should always be subordinate to the com- 
fort of the sick person. 

It is difficult to prop a patient up with 
pillows alone so that she can sit up in bed 
comfortably. Some kind of a bed rest is 
much better behind the pillows. Turn a 
chair upside down on the bed with the legs 
against the head of the bed and the top of 
the back of the chair under the patient's 
hips. This makes an excellent rest, much 
more comfortable than a large pile of pil- 
lows. Small pillows are very useful ; tucked 
under the back, under the knees or wher- 
ever needed, they greatly ease the fatigue 
of lying long in one position. 

The sheets can be changed without dis- 
turbing even a very sick patient. If the 
patient is able to help herself at all, one 
person can do it. If not, there should be 



28 Suggestions on Home Nursing. 

two. To change the under sheet, loosen 
it all around, take it by one side and fold it 
in lengthwise folds, or roll it till you get it 
close tothepatient. Then take the clean sheet 
and fold or roll half of it in the same way 
and lay the folds close to the other. Smooth 
the sheet and tuck it in at the side, then 
work the two folds together carefully under 
the patient, or if she is able to move, turn 
her over on to the clean sheet, which will 
be found very little exertion. The soiled 
sheet can then be drawn away and the clean 
one spread and tucked. The draw-sheet is 
changed in the same way. All this can be 
done without uncovering the patient at all. 
Changing the upper sheet is much easier 
and can be done from either the side or the 
bottom. Loosen the upper sheet and 
blankets from the bottom, and spread the 
clean sheet, beginning from either the 
bottom or the side. Tuck in at the bottom 
and draw out the soiled sheet from beneath 
it. 

In the same connection it may be said 
that to change the patient's nightgown is a 
much easier task than is generally sup- 
posed. For any serious illness it is far 



Beds and Bed Making. 29 

better to open the nightgown down the 
back, which can be done without spoiling 
the garment, as it can be sewed up again 
afterwards. Then it is very simple to put 
the nightgown on over the head and slip 
the arms in, but if the patient is able to 
move and does not wish the nightgown 
altered, put the arms up over the head and 
draw the sleeves down on them, both at 
once; then draw the nightgown over the 
head and it can be pulled down over the 
shoulders with far less exertion than the 
usual way, of putting in only one arm at a 
time. 

Few people realize how much clean 
sheets add to the patient's comfort. 
Change the sheets at least every day, and if 
enough sheets for this cannot be had, then 
at least have a sheet for the night and an- 
other for the day. Often a fever patient 
will drop into a refreshing sleep after a 
smooth, cool sheet is put under her, and 
nothing is more grateful than this change, 
when the patient is restless and the sheet is 
wrinkled and hot. Do not take the upper 
sheet and put it underneath, as is frequently 
done. It is far more important to have the 



30 Suggestions on Home Nursing. 

smooth fresh sheet under the patient, and 
the under sheet should be changed much 
more frequently than the upper. This is 
another case where the patient's comfort 
should not be sacrificed to appearance. 

Crumbs in the bed seem a small detail, 
but they cause great discomfort and some- 
times serious complications. It seems im- 
possible for the most careful person to eat 
in bed without scattering crumbs, which 
get down into the bed and are a fruitful 
cause of bed sores. Twice a day the bed 
should be carefully brushed with a whisk 
broom and not a crumb allowed to remain. 
The patient should be carefully turned, 
first on one side and then on the other, so 
that all the crumbs may be taken away from 
the middle of the bed. It is well when feed- 
ing the patient to tuck the napkin in at the 
neck and spread it under the plate — this 
helps to catch the crumbs. 

BATHS. 

Perfect cleanliness is one of the greatest 
aids to recovery, and there are very few 
patients who cannot be washed without 



Baths. 31 

danger. In almost all cases a sponge bath 
can be given in bed, care being taken not 
to chill or fatigue the patient. The old 
idea that bathing or cool applications in 
fever cases, or even cool water to drink, 
would be dangerous and must be absolutely 
forbidden, is rapidly giving way to the 
newer knowledge that such aids in reduc- 
ing the temperature are of the greatest use 
besides giving untold relief to the patient. 
The temperature of the bath (unless for 
cleanliness only) and the way it shall be 
given should be determined by the doctor. 
Ask him for the most explicit directions, 
and follow them exactly. 

To give a bath in bed, it is well to have 
two old blankets, one folded double under 
the patient, the other over. Have the room 
warm and everything that will be needed at 
hand, towels, soap, hot and cold water, etc. 
A tablespoonful of alcohol in the water is 
refreshing and cleansing and prevents the 
patient from catching cold. Take off the 
nightgown and keep the patient well cov- 
ered with the blankets. Take plenty of 
time to do all thoroughly. Uncover only 
a small part of the body at one time; wash 



32 Suggestions on Home Nursing. 

and dry it and cover, before wetting the 
other portion. Begin by washing the face 
and neck, then take one arm, wash and dry 
that, and so on. Pass the wash-cloth once 
or twice over the part, then rinse the cloth 
and pass over the same place again, and 
then wipe with a towel. The wash-cloth 
can be wrung partly dry, but there is no 
harm in wetting the blankets in which the 
patient is washed. After the bath is over, 
the blankets can easily be dried and put 
away for the next bath. All the bathing 
can be done under the blankets, without 
uncovering the part that is being washed at 
all. When all is done, put on the night- 
gown and remove the blankets and cover 
the patient warmly. If the bath is carefully 
given, the patient need not be exposed at 
all. Protect the bed very carefully so that 
it does not get at all wet. A bath so given 
will be the greatest refreshment to the 
patient, and if carefully done, there is no 
danger of a chill or other bad effect. A 
patient should be bathed at least twice a 
week, and it is often well to give a bath 
every day. Any good soap, Castile, Pears 
or Ivory, may be used. Flannel wash-cloths 



Baths. 33 

are good and there should be plenty of 
towels at hand, and a rubber sheet may be 
desirable to protect the bed in addition to 
the folded blanket. Rough towels are best 
for rubbing the limbs and body and soft 
ones for head, fingers and toes. 

When a cool bath is ordered for a fever 
patient to reduce the temperature, the 
patient is covered only with a sheet, and the 
sponging is done with cool water, or the 
patient may be sponged and wrapped while 
still wet in a blanket. Alcohol may be used 
in the water, as the rapid evaporation aids 
the cooling process. Get explicit direc- 
tions from the doctor as to the kind and 
duration of the bath. 

A wet pack is sometimes ordered for a 
fever patient. To give this lay several 
blankets or a rubber sheet on the bed, and 
over them a sheet wrung out of hot or cold 
water, as directed. Lay the patient on this 
and fold the sheet over her, tucking it 
closely around and between the arms and 
body; then fold the blankets over and leave 
for the length of time directed by the 
doctor. Keep the feet warm by hot appli- 
cations and give plenty of water to drink, 



34 Suggestions on Home Nursing. 

and apply cold water to the head. Dry the 
patient quickly and wrap in a dry blanket. 
A foot bath may be easily given in bed and 
often brings great relief. Take up the 
clothing from the foot of the bed and have 
the patient lie on her back; bend her knees 
and put the feet in a foot tub set on the bed. 
Cover with a blanket and soak the feet for 
a quarter or half an hour. The water 
should be as hot as is comfortable, and hot 
water added when necessary. A table- 
spoonful of mustard mixed smoothly may 
be used in the foot bath, if desired. Dry 
the feet thoroughly and wrap in a blanket. 

The face and hands should be washed 
twice a day ; the teeth brushed or at least 
wiped off with a bit of soft cloth. A few 
drops of listerine or myrrh in the water 
used as a mouth-wash will be refreshing. 
If the patient has much fever and the mouth 
is very dry, a wash of lemon juice and 
glycerine is often helpful. It is very im- 
portant that the mouth be rinsed out each 
time after nourishment is given in fever 
cases, as otherwise the food left in the 
mouth decays rapidly. By turning the 
patient's head on one side and placing a 



Baths. 35 

shallow dish at the corner of her mouth, 
she can rinse the mouth comfortably and 
spit out the fluid into the little basin or cup. 

The hair should be evenly parted from 
the forehead to the back of the neck and 
braided in two braids, starting from behind 
each ear. In combing the hair, do only one 
side at a time, beginning at the end of the 
strand and keeping the upper part of it 
wrapped tightly around the finger between 
the comb and the head, so as to avoid pull- 
ing the scalp as much as possible. If the 
hair becomes tangled while the patient is 
too weak to have it combed, moisten a 
small part of the hair at a time with alcohol 
and ammonia mixed ; half of each. Do not 
try to comb all the hair at once; do part 
and let the patient rest before going on. 

The patient may be rubbed with alcohol 
daily, in many cases, with excellent results. 
This is refreshing in fevers, and soothing 
when done at night. Wherever there is 
danger of bed-sores, on the back and end 
of the spine especially, alcohol should be 
freely used. A red spot on the skin is the 
first sign of a bed-sore and should be at- 
tended to at once, and the pressure relieved, 



36 Suggestions on Home Nursing. 

if possible, by means of a rubber ring air 
cushion, or by small pillows. It is often 
well to rub a patient with sweet oil or cocoa 
butter, which keeps the skin in good condi- 
tion and is strengthening also. 

USE OF THE BED PAN. 

When the doctor has ordered that a 
patient is not to get out of bed at all, it is 
very important that she should at once 
learn to use the bed pan, and though this 
may at first seem very difficult, it should be 
persevered in throughout the illness, as the 
exertion of sitting up very often causes 
dangerous exhaustion. Protect the bed 
thoroughly by placing a rubber sheet or 
pad covered with an old sheet or towel 
under the patient from the waist to the 
knees. A very good pad for this purpose 
may be made of three or four large news- 
papers opened and laid together and cov- 
ered as above. If the patient is not nerv- 
ous about the danger of soiling the bed, she 
will be much more likely to be able to use 
the bed pan easily. Assure her that the 
bed is protected and that soiling it is of 



Use of the Bed Pan. 37 

no consequence. Turn down the covers 
nearly to the knees and cover the upper 
part of the body thoroughly with a separate 
blanket or old shawl, so that the patient 
need not be exposed at all. Draw up the 
knees so that the soles of the feet rest flat 
against the mattress, and tell the patient to 
press firmly downward with her feet so that 
the hips will be raised from the bed about 
two inches, and the pan can be easily 
slipped under her. Be sure that it is far 
enough under her so that the edge of the 
open part of the pan shall be well behind 
the end of the backbone. Always have the 
bed pan thoroughly warm, as the shock of 
the touch of anything cold is not only dis- 
agreeable, but very bad for a sick person. 
If the patient is very stout, it may be well 
to slightly oil the edge of the pan so that it 
may be more easily slipped under her; or 
when the patient is thin, a cotton pad on 
the back of the bed pan where it presses 
against the hips and the end of the back- 
bone will make it more comfortable. The 
nurse should help the patient to raise her- 
self by putting one hand under the hips and 
lifting upward at the same time that she 



38 Suggestions on Home Nursing. 

slides the bed pan under the patient. Care 
should be taken never to push the pan 
under forcibly, as the skin at the end of the 
backbone may easily be broken in this way 
and a bed-sore then started. For a patient 
who is unable to move her limbs at all, it is 
much more comfortable to have someone 
lift the hips by placing one hand on each 
side and lifting slowly and gently while an- 
other person slips the bed pan under. 
When a person is too weak for even the exer- 
tion of being placed on the bed pan, pads of 
common cotton, rags or old muslin may be 
used to receive the excretions passed from 
the bowels and bladder. They should be 
at once burned or buried after they have 
been used. Nervous persons who find it 
difficult to pass the urine may be relieved 
by having some very hot water in the bed 
pan so that the steam will rise against them, 
or by pouring a cup of warm water over 
the parts between the thighs so that it will 
trickle down into the bed pan, or by taking 
a drink of water while on the bed pan. 
Sometimes a hot-water bag, less than half 
full, laid over the bladder for a few mo- 
ments will also be found useful in this way. 



Enema t a or Injections. 39 

The patient should never be hurried when 
trying to use the bed pan, but it is not best 
for her to stay on it for more than fifteen 
minutes or half an hour at the utmost, as 
the position is very tiresome. It is much 
better to take it out and bring it back 
again when necessary. A small cushion 
placed under the small of the back before 
placing the bed pan under the patient may 
make her more comfortable. 

When the patient is a man a urinal is 
more convenient than a bed pan; a wide- 
necked bottle answers this purpose and can 
easily be used in bed without exposure. 

ENEMATA OR INJECTIONS. 

An enema is a fluid injection into the 
rectum, and is given either to relieve con- 
stipation, to give nourishment, or for heal- 
ing purposes. The injection or enema for 
relieving constipation is in general use, and 
it is very important to know how to give it 
properly. 

A Davidson or bulb syringe, or a foun- 
tain syringe may be used. A flexible long 
rubber rectal tube is much better than the 



40 Suggestions on Home Nursing. 

hard nozzle which is commonly used, as by 
carrying the enema farther up, it is retained 
with less difficulty and acts more effec- 
tively. The nozzle should be oiled, and in- 
serted very gently and gradually; there is 
then no danger of the long nozzle being in- 
serted too far. About a quart of lukewarm 
water is usually enough. Make a suds with 
Castile soap, or common brown soap, or use 
one tablespoonful of gylcerine in a quart of 
water; pass the water through the bulb 
syringe once or twice to expel the air, or 
run through the tube if a fountain syringe 
is used ; then insert the nozzle and proceed 
very gradually. If the patient complains 
of much pain, stop and rest and then go on. 
Take plenty of time. When enough water 
has been injected, withdraw the nozzle 
slowly, and press a folded towel against the 
rectum, to assist in retaining the enema, for 
fifteen or twenty minutes, if possible, in 
order to soften the accumulations. Oil, 
salt or other additions to the water enema 
should be according to the doctor's direc- 
tions. 

A gentle rubbing of the abdomen, up the 
left side and towards the right, while the 



Enemata or Injections. 4 1 

enema is being given, is a help in retaining 
it, as is also a constant slight pressure on 
the rectum. When hot water can be used 
instead of lukewarm, there is much less 
griping. 

Should the patient be greatly troubled 
with wind in the bowels, relief may be given 
by inserting a long rubber rectal tube into 
the rectum and letting it remain a short 
time ; the gases will gradually escape in this 
way. 

When food cannot be retained on the 
stomach, nourishment may be given by the 
doctor's orders through the rectum. This is 
done by inserting the long rubber rectal 
tube as before; then putting a funnel in 
the end of the tube instead of the syringe, 
and pouring the nourishment through, 
very slowly, as it is to be retained. With- 
draw the tube very slowly and press a 
folded towel against the rectum. Pepton- 
ized milk, or a raw egg with salt, or beef 
juice are most often given in this way, and 
usually once in four or five hours. Only 
two or three ounces can be given at a time. 
If there is trouble in retaining the nourish- 
ment, the bowels should first be washed 



42 Suggestions on Home Nursing. 

out with plain water, half an hour or an 
hour before giving nourishment, so that the 
bowels may have rest and be quiet in order 
to retain the food enema. 

The syringe must be washed with the ut- 
most care. Let first cold and then hot 
water be run through it. Never stick the 
nozzle into the bag of the fountain syringe 
for convenience in carrying. The nozzle 
and rectal tube should be disinfected 
always in a solution of one part carbolic 
acid to twenty parts water (three tea- 
spoonfuls of carbolic to one pint of water), 
or one part bichloride of mercury to one 
thousand parts water. (Bichloride of mer- 
cury tablets with directions for use can be 
procured from druggists.) 

One or the other of these solutions 
should be on hand in a sick-room, and the 
syringe nozzle, bed pan, etc., should be dis- 
infected with them. Glass douche nozzles 
can be boiled, and all cloths, etc., must be 
boiled. • Ordinary cleansing does not re- 
move the germs of any contagious disease. 
They must be destroyed either by boiling 
or by disinfectants. 



Douches. 43 

DOUCHES. 

By a douche is usually meant a stream of 
water sent with some force upon a limited 
surface. Douches are given for cleanliness, 
for their stimulating effect, or to relieve in- 
flammation. Like other baths they may be 
simple or medicated. The vaginal douche 
is the one most frequently used, but should 
be taken only when ordered by a doctor. 
He will direct whether it is to be of clear 
warm water or whether carbolic acid or 
some other disinfectant is to be added. 

A fountain syringe with a glass douche 
nozzle attached is the best instrument to 
use. Before the nozzle is inserted a stream 
of water should be made to flow through it 
until it flows warm. The nozzle should 
then be introduced well up towards the 
back wall of the vagina. If no special 
amount of water is ordered, a quart or 
three pints will be enough. If given for 
cleansing purposes it need be only warm, 
about 95 to ioo° Fahrenheit; but if for 
reducing inflammation, it ought to be 
warmer, from 105 to 115 Fahrenheit. 
Ask the doctor what temperature is best. 



44 Suggestions on Home Nursing. 

The douche should always be given with 
the patient on her back. Even if she is up 
and around, she should lie down for such 
treatment. 

A glass nozzle is the only one that can 
be kept perfectly clean. After being used 
it should be washed with soap and water, 
thoroughly rinsed, and then should be kept 
in an open-mouthed bottle in water and a 
little carbolic acid. 

OUTWARD APPLICATIONS. 

Rubber hot-water bottles covered with 
flannel are most convenient, but glass 
bottles tightly corked and wrapped in 
flannel answer every purpose. Patent beer 
bottles with rubber stoppers make excel- 
lent hot-water bottles. Do not set a hot- 
water bottle in front of the fire or stove to 
heat, as it is likely to burst. Fill it care- 
fully with hot water from a kettle. Flannel 
bags filled with salt or bran, and heated in 
the oven, are excellent. Be very careful not 
to burn the patient with hot-water bottles ; 
a weak or unconscious person may be 
burned very seriously with heat that would 
not burn a well person. 



Outward Applications. 45 

To apply moist heat, wring flannel cloths 
out of hot water, apply and cover with an- 
other flannel, or cotton wadding basted to 
oiled silk, to retain the heat. These hot 
cloths are called stupes. To wring the 
cloths without burning your hands, have a 
stupe wringer, which is a piece of stout 
toweling with a stick run through a hem at 
each end. Put the stupe in the middle of 
this, dip in boiling water, and twist the 
sticks in opposite directions till the water 
is wrung out. Try the stupes on the back 
of your hand or your elbow to see that it is 
not hot enough to burn. Small pieces of 
flannel may be squeezed in a lemon 
squeezer or towel. For cold applications, 
wet cloths may be laid on ice and changed 
every five minutes, or cloths wet in alcohol 
may be used. To keep ice for this purpose, 
turn a bowl upside down in a pan and set 
the ice on this to keep it out of the water; 
ice will last much longer in this way. The 
cloths can be wrung out of the water in 
the pan, and laid on the ice a moment 
before using. Small rubber bags filled with 
cracked ice and salt are good. 
All hot applications should be changed fre- 



46 Suggestions on Home Nursing. 

quently and very quickly, and when finally 
removed the part should be covered in- 
stantly with flannel, or with a layer of 
cotton wadding and oiled silk, as the skin 
is then especially sensitive to cold. Be 
very careful not to apply a stupe too hot, 
especially with a weak or unconscious 
patient, who may be seriously burned by 
a heat which would not burn a well person. 
These hot cloths give great relief to sprains 
or bruises. Either hot or cold compresses 
are often useful to relieve headache or in- 
flammations. 



POULTICES. 

Poultices are in common use as a conven- 
ient means of applying heat and moisture. 
Be careful not to burn the patient. A child 
or a very weak or unconscious person, or 
one with paralysis, is easily burned. If you 
can hold the poultice to your cheek for a 
second it is safe to apply. A poultice will 
not keep warm longer than four hours, and 
a thin one will cool quicker than a thick 
one. Cover the poultice with a piece of 
flannel, old blanket, or cotton wadding 



Poultices. 47 

basted on oiled silk, to keep the heat in. 
Make the poultice bag of old muslin, a 
third longer than you wish the poultice to 
be. Turn back the top, fill up the bag, pull 
up the top, fold the end over once or twice, 
and baste or fasten securely with a safety 
pin. If there is no running sore or con- 
tagious disease, the same poultice may be 
used several times by turning the bag inside 
out, scraping the poultice off with a knife 
and reheating in a saucepan. The poultice 
bag should be carefully washed each time it 
is used. Always have two or three extra 
poultice bags ready. 

Flaxseed Poultice. — Have a clean sauce- 
pan of boiling water. Sprinkle in ground 
flaxseed, a little at a time, and stir constantly 
until thick enough to cut with a knife, then 
beat for several minutes till light and 
smooth. A little olive oil added will help 
to keep it soft. 

Bread Poultice. — This is lighter than flax- 
seed, but cools quickly, and does not hold as 
much moisture. Pour boiling water over 
the soft part of bread and let it simmer. 
Drain off the water, beat with a fork. Do 
not use milk as it soon sours. 



48 Suggestions on Home Nursing. 

Charcoal Poultice. — Put charcoal into a 
bread poultice and sprinkle some over the 
poultice when it is spread on the cloth. 

Starch Poultice. — The starch is made as 
for laundry use. 

Hop Poultice. — Fill a thin bag with hops 
and wring out of hot water. Bran poultice 
is made in the same way. 

Spice Poultice. — Use one teaspoon each 
of ginger, cinnamon, cloves, and cayenne 
pepper, with flour enough to make a paste. 

Mustard Plaster. — Use one part mustard 
to four parts or more of flour or flaxseed 
meal, add water enough to make a paste, 
spread rather thin on the cloth. It is well 
to oil the parts before applying a mustard 
plaster, to prevent blistering ; or take equal 
parts mustard and flour and mix with 
molasses or white of egg instead of water, 
to prevent blistering. A wet flannel in- 
stead of muslin poultice cloth is sometimes 
better for a mustard plaster. Be very care- 
ful in folding the edges, not to have a 
crumb of the mustard touch the skin. 



Contagious Diseases. 49 

CONTAGIOUS DISEASES. 

There are certain necessary precautions 
to prevent the spread of contagious diseases 
which should be familiar to every one, and 
be carried out with the utmost care. 

Every unnecessary article should be 
taken out of the sick-room before the 
patient is put into it, and afterwards every 
article taken out of the room must be dis- 
infected. Hang a sheet wrung out of a dis- 
infectant solution outside the door of the 
sick-room, so that the air of the room may 
not blow through the rest of the house. 
The disinfectants before mentioned, one 
part carbolic acid to twenty parts water, 
or one part bichloride of mercury to one 
thousand parts water, should be kept on 
hand and freely used. 

Sheets, towels, etc., should be soaked in 
disinfectants, washed by themselves and 
boiled. Carbolic is the best, as bichloride 
discolors them. One-half pint carbolic to 
five quarts of water is the right proportion. 
There should be an abundant supply of old 
muslin pieces or cheese cloth, to be used in 
place of handkerchiefs, if there is discharge 
4 



50 Suggestions on Home Nursing. 

from the nose and mouth, or for washing 
or dressing wounds, and these should be 
immediately burned. In consumption or 
pneumonia cases, special care should be 
taken of all sputum, which should on no 
account be allowed to become dry, as the 
contagion is carried through the dried 
particles containing germs being taken into 
the lungs. A sheet of paper folded in the 
form of a box will be found convenient for 
receiving the sputum, and can be readily 
burned. Any handkerchiefs used should at 
once be soaked, and not allowed to become 
dry before being disinfected and boiled. In 
typhoid fever, the infection is greatest from 
bowel discharges, which must be disinfected 
w T ith the utmost care. For this purpose 
use common lime mixed with water to the 
consistency of cream. Add to the bowel 
discharge an equal quantity of this prepara- 
tion of lime, stir with a stick and let it stand 
a short time in the pan before being 
emptied. 

The nurse should wear only wash 
dresses, with a cap over her hair, and 
should change her dress before going out. 
She should take a walk in the fresh air 



Disinfectants. 5 * 

every day, and keep herself as well as pos- 
sible, to avoid risk of contagion. The 
patient's room should be kept scrupulously 
clean and well aired, as the only way to dis- 
infect the air of a room is to change it for 
fresh air. 

In skin diseases, such as scarlet fever, the 
skin should be oiled or rubbed with car- 
bolized ointment to keep the particles from 
flying in the air. Charcoal in open pans, or 
carbolic crystals, will help to remove the 
offensive odors. Chloride of lime is good 
to throw down drains or water closets. 
See that there is nothing in the room or 
under the windows which has any offensive 
odor. This rule applies in cases of ordinary 
sickness, as well. 

DISINFECTANTS. 

Carbolic Solution. — Get seventy-five per 
cent, solution of carbolic acid from the 
druggist. Mix one part of this with twenty 
parts of hot water. Stir well and let it 
cool. One-half pint of carbolic to five 
quarts of water is the right proportion, or 
three teaspoonsful to one pint of water. 

Bichloride of Mercury. — Get a bottle of 



52 Suggestions on Home Nursing. 

bichloride of mercury tablets from the 
druggist, and dissolve in water, according 
to directions on the bottle, to make a solu- 
tion of one part bichloride to one thousand 
parts water. 

COOKING FOR THE SICK. 

Proper nourishment, fresh air and clean- 
liness are the three most potent aids to the 
recovery of a convalescent patient. Food is 
quite as important as medicine to the sick, 
and should be prepared and given with as 
much care and regularity. It is very necessary 
to give nourishment at frequent intervals 
to a sick person, as the weakened stomach 
is incapable of digesting enough food to 
last from one mealtime to another. Food 
should be given every two hours, and only 
a small quantity at a time. Milk is the most 
useful food for the sick and every one 
should accustom himself to it when well, 
so as to be able to take it easily. If it is 
disliked, the addition of lime water or 
vichy, or salt, or even diluting it with water, 
may make it more palatable. It should be 
either very cold or very hot. When milk is 



Cooking for the Sick. 53 

heated, be very careful that it does not boil. 
Heat it in a vessel placed in a pan of hot 
water and take it out the moment it is hot 
enough. 

Mutton broth is excellent. Beef juice is 
very valuable. Take lean beef from the 
round, cut into small pieces and just sear 
it over the coals or in a hot pan. Then 
squeeze the pieces in a lemon squeezer. 
Serve hot with a pinch of salt. 

To make mutton broth, take a neck of 
mutton, cut in small pieces, cover with cold 
water and let it boil very gently till the 
meat drops off the bones. Add salt to taste, 
strain and cool quickly; when cold, remove 
every particle of fat, and heat as required. 

Cold beef juice may be made by cutting 
fresh lean beef into small pieces, and put- 
ting it into a bowl with cold water, two 
tablespoonsful of water to every ounce of 
beef; add salt, let it stand twenty minutes. 
Strain, set it on the ice and serve very cold. 

For beef tea, take a pound of lean beef, 
cut it small and put in into a double boiler 
(or a bowl set in a saucepan of boiling 
water), with one pint of cold water. Let it 
heat, and cook for twenty minutes after it 



54 Suggestions on Home Nursing. 

is hot. Pour off from the meat, but do not 
strain, season with salt and pepper to taste. 
If beef tea is allowed to boil it will separate. 

Beef for broth should be cut into very 
small pieces, and it will be found easier to 
do this with scissors instead of a knife. 

Take the white of one egg, and a table- 
spoonful of ice water, beat to a froth, let it 
stand till it becomes liquid. Use a table- 
spoonful in lemonade or orange juice. 
This is very nourishing and refreshing. A 
tablespoonful in brandy is valuable in 
diarrhoea. 

Soft boiled eggs are also necessary. To 
cook them properly, put the egg into cold 
water and set on the stove ; when the water 
simmers, the egg is done; or put the egg 
into a saucepan of boiling water, which take 
off at once from the stove and set on the 
hearth ; the egg will be done in five minutes. 
Either makes the egg more delicate than 
boiling it. 

Poached eggs are apt to have an edge of 
hard cooked white around them, which is 
indigestible and is especially dangerous to 
a typhoid-fever patient. When the patient 
cannot take solid food, eggs should be 



Cooking for the Sick. 55 

given raw, and can be made palatable in a 
variety of ways. Perhaps the best is a milk 
shake. Break an egg into a tumbler, add 
a spoonful of very finely crushed ice, and 
half a glass of milk, invert another tumbler 
over the first, hold the tumblers together 
in both hands and shake rapidly up and 
down. With a little practice, this may be 
done without spilling at all. Strain into a 
clean glass, add a pinch of salt and serve 
at once. The egg may be beaten with an 
egg-beater till very light, then the milk 
added, but the patient tires of it more 
quickly this way. The whites of one or two 
eggs beaten to a froth and mixed with 
orange juice, is both nourishing and 
delicious. 

Give patients all the cold water they want 
to drink, unless it is expressly forbidden by 
the doctor. In fever cases especially it is 
important to give plenty of cold water, and 
there is no danger in giving cold water in 
eruptive skin diseases, such as measles and 
scarlet fever, unless especially prohibited 
by the physician. 

Much needless suffering and positive 
injury has been caused by the old idea that 
LofC. 



56 Suggestions on Home Nursing. 

water must be withheld from fever patients. 
Hot water may often be given to fever 
patients, and, where there is suffering from 
nausea, with great relief. Lime water is 
also helpful for nausea. 

To keep ice in a sick-room, turn a bowl 
upside down in a pan and set the piece of 
ice on the bowl ; this will keep it out of the 
water and it will last much longer. If an- 
other large bowl is inverted over it, and the 
whole wrapped closely in newspaper or 
flannel, it will keep for a surprising length 
of time. 

Ice may be cracked by putting it in a 
cotton bag and pounding it with a mallet 
or heavy stick. If it is necessary to crack 
ice in the room, it may be done by press- 
ing a small sharp awl or a stout shawl pin 
into the ice, which will splinter off very 
readily. 

Milk toast may be given as soon as any 
solid food is permitted. Toast the bread 
carefully, and dip in hot milk with a little 
salt in it. Stir the milk while heating it. 
Do not boil or thicken the milk, as it would 
then have a tendency to produce constipa- 
tion. Boiled milk is often verv useful in 



Cooking for the Sick. S7 

checking diarrhoea. Water toast is often 
relished. Toast the bread carefully, dip it 
in hot salted water, put it on a hot plate 
and butter it. 

Clam juice is nourishing, and may be ob- 
tained by putting perfectly fresh clams, 
washed clean, into a pan and setting in the 
oven till the shells open. The juice may 
then be strained off and heated, with hot 
water added if too salt, or milk may be 
used. The clam broth put up in bottles is 
often useful, as is also good canned bouil- 
lon, and the beef extracts. 

Chicken broth or jelly is excellent. Cut 
up an old fowl, cover with cold water, sea- 
son with salt and pepper and a few celery 
leaves if you have them. Boil very slowly 
till the meat is all in rags. Strain and cool 
quickly. When cold remove the fat, and 
serve cold as jelly, or heat and add milk or 
cream to taste. 

To make dry toast, do not toast over the 
fire, leaving the inside of the slice raw. Cut 
the bread thin and put it in the oven until 
it is nicely browned and crisp all through. 
Untoasted bread should not be given as it 
will produce indigestion. 



58 Suggestions on Home Nursing. 

In making gruels, the main thing is to 
cook them a long time, as the starchy sub- 
stances of which they are made require to 
be thoroughly swelled . and completely 
cooked to be digestible at all. Milk is a 
better food than gruels for most sick 
people. 

When the patient begins to eat solid 
food, see that everything is properly 
cooked and nourishing. Avoid rich or 
sweet things. Nothing fried should be 
given to an invalid. If you have nothing 
but a frying pan to cook with, put a little 
water in it and stew the food instead of fry- 
ing. Fried ham is indigestible and should 
never be permitted. Cake, pies and rich 
preserves should be forbidden. Fresh 
meat, broiled or roasted, chickens, well 
cooked cereals, boiled rice, well cooked 
green vegetables, baked potatoes, eggs 
(not hard boiled), oysters and fish if per- 
fectly fresh, baked apples, simple custards 
and blanc manges and ice cream are all 
suitable. Plain ice cream made of cream 
or milk and eggs is usually relished by in- 
valids and is nourishing. Fresh fruit, ex- 
cept pears, is excellent. Grapes without 



Stray Notes. 59 

the seeds, oranges and grape fruit are most 
digestible. 

All food for invalids should be served 
in the daintest manner possible. Have the 
tray covered with a clean cloth. Bring only 
a small quantity of food at a time as a large 
dish takes away the appetite. 

Have hot things very hot, and cold 
things very cold. Do not ask sick people 
what they would like ; the effort of thinking 
is a weariness, and the element of surprise 
may tempt the feeble appetite. Take the 
tray, dishes and napkins out of the room 
the moment the meal is ended. 



STRAY NOTES. 

Liniments are made more effective by 
washing the parts with warm water before 
applying. 



To make a pneumonia jacket, take a 
high-necked undershirt, split it on one side 
and one shoulder, baste cotton batting 
firmly front and back, wherever the doctor 
wishes it ; put it on with the cotton next the 



60 Suggestions on Home Nursing. 

skin (after oiling the skin according to the 
doctor's directions), and fasten it up the 
side and shoulder with safety pins. 



For earache, take a little cotton batting, 
spread thin and sprinkle with black pepper, 
fold and tie into a round ball, oil the out- 
side and lay it in the ear; this is very effica- 
cious, especially with children. 



For burns, apply at once a paste made 
of common baking soda (not washing soda) 
and water. Make the paste smooth, spread 
it thickly on the burn ; put more of it on a 
wet cloth and lay over the burn, and wrap 
with more wet cloths, and keep the whole 
moist. If sweet oil is at hand, a still 
better way is to beat sweet oil and soda to 
a cream and apply very thickly on the burn, 
and cover with a quantity of cotton wad- 
ding or absorbent cotton and cheese-cloth 
bandages. Do not disturb the dressings of 
a burn oftener than is necessary, as the 
pain is increased by admitting air to the 
burned surface. If the burn is at all serious 
a doctor should be summoned at once. 



Stray Notes. 61 

For cuts, scratches, wounds or bruises, 
wash in very hot water which has been 
boiled. Never apply unboiled water to any 
cut, as there is danger of infection and 
festering. After the wound is perfectly 
clean, bandage with soft muslin. If there 
is much bleeding, apply styptic cotton, or 
a pad of old muslin pressed firmly on the 
wound. Hot water is also the best thing to 
apply to a sprain — keep the limb under 
water as hot as can be borne for half an 
hour, before bandaging. 



INDEX. 



Alcohol, for rubbing, 35 
For baths, 31 



Baths: 

Cold, 33 

Hot, 31 

Foot, 34 

In bed, 31 

For fever, 35 
Bed. 

Arrangement of, 24 

Making, 25 

Feathers, 24 

Mattress, 24 

bneets, 25 

Blankets, 26 

Spread, 27 
Bed pan, use of, 36 
Bed rest, how to make, 27 
Bed sores, prevention of, 25, 

35 
Beef juice, 53 
Beef tea, 53 

Bichloride of mercury, 51 
Bread poultice, 47 
Bronchitis, 16 
Bruises or cuts, 61 
Burns, 60 



Carbolic acid, 51 
Changing sheets, 2j 
Charcoal, 48, 51 
Coal, to replenish without 
noise, 24 



Cocoa butter, for rubbing, 36 
Cold applications, 45 
Cold pack, 45 
Compress, 45 
Consultations, 20 
Contagious diseases, 49 
Convalescents, food for, 52 
Cooking for the sick, 52 
Crumbs, in bed, 30 

Disinfectants, 51 
Disinfection in contagious 

diseases, 49 
Douches, 43 
Draw sheets, 25 

Earache, 60 
Enemata: 

Simple, 39 

Nourishing, 41 
Eggs: 

Boiled, 54 

Raw, 54 

Whites of, 54 



Fevers : 

Baths for, 33 

Water for, 55 

Contagious, 49 

Disinfection, 49 
Fires : 

Open, 13 

To replenish, 24 
Flaxseed poultice, 47 



6 4 



Index. 



Food for the sick, 52 
Foot baths, 34 
Fried food, 58 
Fruit, 58 

Glycerine injections, 40 
Gruels, 58 

Hair, care of, 35 

Heating, n 

Hot applications, 44, 45 

Hot pack, 33 

Hot salt bags, 44 

Hot water bottles, 44 



Ice, to keep, 56 
Ice bags, 56 
Injections: 

Cleansing, 40 

Nourishing, 41 

Liniments, 59 
Lime water, 56 

Medicines, how to give, 19, 

20 
Milk, value of, 52 
Milk shake, 55 
Mouth wash, 34 
Mustard plaster, 48 
Mutton broth, 53 

Nightgowns: 

How to change, 28 
Nourishment, liquid, 52 
Nurse, duties of, 17 

Open fires, 13 
Orange juice, 54 



Outward applications, hot, 44 
Cold : 45 

Pillows, 27 
Pneumonia, 16 
Pneumonia jacket, 59 
Poultices, 46 

Rectal tube, long rubber, 39 
Rubber sheet: 

Substitutes for, 25 
Rubbing: 

Alcohol, 35 

Cocoa butter, 36 



Sheets: 
How to change, 27 
How to fasten, 25 
Rubber, 25 

Sprains, 61 

Stupes, 45 

Stupe-wringers, 45 



Teeth, care of, 34 
Temperature: 

Of rooms, 14, 16 

Of baths, 31 
Toast, 56 
Typhoid fever, 50 



Ventilation, 11 

Water: 
Boiled, for cuts, 61 
For fever patients, 56 
Hot, 56 

Water bottles, hot, 44 

Water toast, 57 

Wounds, 61 



D'EC 22 1903 




DDDEb77]iDSS 



